Custom Packaging / Shipping Inquiry

Kel-Ex provides custom packaging services for dangerous goods, and can assist you in arranging shipment via approved carriers.

Please provide information in the form below for our review. We will contact you with any further questions and a quotation.

* required fields

Shipper
Consignee
Company*
Address*
City*
Province*
Postal Code*
Contact Name*
Telephone*
Fax
Email*
Company*
Address*
City*
Province*
Postal Code*
Attention*
Telephone*
Shipper's Shipment Reference Number (if applicable)
Consignee's Shipment Reference Number (if applicable)
If Kel-Ex is shipping directly to the Consignee, WHICH CARRIER IS TRANSPORTING THIS SHIPMENT?
Direct Shipment Company
If using Shipper Account Number, enter it below:
If using Consignee Account Number, enter it below:
If you are using a FREIGHT FORWARDER, please specify the following items:
Company:
Contact Person:
Email:
Telephone:
Fax:
How is the shipment travelling?* Ground Air Marine
If by AIR, is the shipment being transported by a CARGO ONLY AIRCRAFT *
(* a plane with NO passengers - please contact freight forwarder or carrier if unsure) 		Yes No
If by MARINE or GROUND, does Kel-Ex need to supply placards? Yes No
Do you know what the Dangerous Goods are Classified as? *
YES, as specified below:
Item
 UN# Proper Shipping Name Class Flashpoint
(centigrade)		 Packing Group
a
b
c
NO. A Material Safety Data Sheet for each item has been Faxed, or Emailed to shipping@kel-ex.com
Provide the total Net Quantity of Packaging Info for each Dangerous Good Being Shipped
Item
 Net Quantity (Kg/L*) # of packages Package Material Type of Package (box, drum, etc) Are there Inner packagings? (Y/N) Inner Package Material How many Inner packagings per package Quantity in each Inner package (Kg/L)
a
b
c
* Solids = Kg (kilograms), Liquids = L (Litres), Gases: Air = Kg; Marine or Ground = L
For MARINE, the Gross Weight for each Dangerous Good is: For Item a: For Item b: For Item c:
Are these UN PERFORMANCE PACKAGING?*
(recognizable by the spec code on the top/bottom/edge of the container
eg. UN1A2/Y40/S/07)

Yes No

 
Billing Information
Do you have an Account with Kel-Ex:* Yes, then please provide P.O. Number
  No, then provide the following information:
Billing Party's Address: Same as the "Shipper" Address Above
A Different Address, provide details below:
Alternate Billing Party's Address Details:
Credit Card Type:
Credit Card Number:
Credit Card Expiry: (MM/YY)
Name on Card:
Signature
I,* CERTIFY THAT THE ABOVE INFORMATION IS CORRECT.
Do you have any other instructions or special requests?